Iatrogenic Burden of Atopic Dermatitis

Raj Chovatiya, Jonathan I. Silverberg*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


The management required for atopic dermatitis (AD) may worsen patient burden, thereby resulting in iatrogenic burden, that is, morbidity caused by medical treatment. We sought to describe the iatrogenic burden of AD and conducted a narrative review of key areas that clinicians can address to minimize it. Clinicians should think strategically about itch trigger avoidance, encourage slow incorporation of lifestyle changes, and emphasize step-up therapy when avoidance becomes too burdensome. Out-of-pocket treatment costs should be incorporated into shared decision making to balance affordability, preference, efficacy, and safety. Polypharmacy should be minimized by eliminating ineffective, nonevidence-based, and redundant therapies while appropriately stepping up to advanced therapy. Clinicians should take adequate time to communicate, the impact of AD on quality of life, and incorporate evidence-based guidelines. The multidimensional nature of AD requires a dynamic approach. Future guidelines should incorporate step-up, step-down, and maintenance approaches to reduce treatment burden and improve quality of life.

Original languageEnglish (US)
Pages (from-to)S17-S23
Issue number6
StatePublished - Nov 1 2022

ASJC Scopus subject areas

  • Immunology and Allergy
  • Dermatology


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